Carer-reported measures for a dementia registry: A systematic scoping review and a qualitative study.

Objectives: Informal carers play a critical role in supporting people with dementia. We conducted a scoping review and a qualitative study to inform the identification and development of carer-reported measures for a dementia clinical quality registry.

Methods: Phase 1-Scoping review: Searches to identify carer-reported health and well-being measures were conducted in three databases (MEDLINE, PsycINFO and Embase).

Barriers and enablers to consumer and community involvement in research and healthcare improvement: Perspectives from consumer organisations, health services and researchers in Melbourne, Australia.

Partnering with consumers and patients and the community and public is a research and healthcare improvement imperative. Consumer and community involvement (CCI) requires behaviour change at the individual (researcher, health professional, manager), organisational (health service, university, medical research institute) and system level (funding policies, collaboration between organisations). To understand the barriers and enablers to meaningful CCI, a qualitative descriptive study was undertaken with researchers, health professionals, representatives from consumer organisations, and health services and ethics committees in Melbourne, Australia.

Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic: A Consensus Statement.

Importance: The COVID-19 pandemic is the greatest global test of health leadership of our generation. There is an urgent need to provide guidance for leaders at all levels during the unprecedented preresolution recovery stage.

Objective: To create an evidence- and expertise-informed framework of leadership imperatives to serve as a resource to guide health and public health leaders during the postemergency stage of the pandemic.

"Call Me by My Name": Improving Communication with Family Members at the Bedside via the Caregiver Identification Badge.

Background: Patient and family experience are integral to the care that we provide. In the pediatric hospital setting, multiple family members are directly involved in patient care. We identified the need for greater caregiver name recognition at The Hospital for Sick Children, Toronto, ON.

How Can Quality of Dementia Care Be Measured? The Development of Clinical Quality Indicators for an Australian Pilot Dementia Registry.

Background: A clinical quality registry (CQR) for dementia provides benefits to those living with dementia and their carers by improving the quality and experience of care through benchmarking and monitoring patient outcomes. CQRs use data collected to form clinical quality indicators (CQIs) through which variations in clinical processes and outcomes between different services and jurisdictions can be highlighted.

Objective: This modified Delphi study aimed to develop CQIs for a pilot Australian CQR for dementia and mild cognitive impairment.

Patient-Reported Outcome Measures to Inform Care of People With Dementia-A Systematic Scoping Review.

Background And Objectives: Patient-reported outcome measures (PROMs) captures the patient's perspective regarding quality of life, daily functioning, symptom severity, and overall health, and how these may be impacted by health care or other interventions. PROMs are used in clinical quality registries (CQRs) for a number of diseases to assess the patient's perspective of the impact of clinical care on quality-of-life. This scoping review aimed to identify dementia-specific PROMs, determine how the PROMs are being used, and whether they are used within dementia registries.

Physician Experience at the Leading Edge of the Digital Healthcare Transformation.

Physicians as a group have a highly variable love/hate relationship with digital technology: there is no doubt that digital technology has the potential to dramatically improve the care that we provide to our patients; however, it also has the potential to negatively disrupt how we work and interact with one another and may even cause harm, albeit rarely (Wachter 2015). One suspects that this trade-off is similar to what has been experienced by society as a whole as we have undergone the digital revolution over the past two decades. For example, although digital platforms have allowed us to stream more music than could ever be purchased by one individual, it comes at the cost of sound quality.

Switching from expectorated to induced sputum cultures for tuberculosis diagnosis reduces cost without increasing risk.

Active pulmonary tuberculosis testing with 3 expectorated sputa can increase isolation days and expenditures compared with 1 induced sputum. Six-month retrospective and prospective chart reviews were conducted, and a screening algorithm was phased into 2 hospital sites. With induced sputum testing, isolation decreased from 7 to 4 days (interquartile range, 4-3, P = .

The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review.

Purpose: In suspected spondylodiscitis and vertebral osteomyelitis, computed tomography (CT)-guided biopsies are often performed to determine a causative organism and guide antimicrobial therapy. The aim of this study is to determine the diagnostic culture yield of CT-guided biopsies performed in cases of suspected spinal infections.

Methods: A literature search of PubMed and MEDLINE up to April 2017 was performed for keywords "CT guided vertebral biopsy infection," "CT-guided spine biopsy infection," "CT guided spine biopsy yield," and "CT guided vertebral biopsy yield.

Healthcare Quality Improvement Requires Many Approaches.

It is a pleasure to respond to the commentaries and we thank the authors for the thought, time and effort they so obviously put into their writing. We are excited that documenting our experience has resulted in such a wide range of opinion.

Five years of Experience using Front-Line Ownership to Improve Healthcare Quality and Safety.

Front-line ownership (FLO) is a complexity science-based approach to leading change initiatives that is built upon a foundation of Positive Deviance and the use of Liberating Structures to engage others. In this paper, we outline the use of FLO in four successful patient safety or quality improvement projects in four countries. While the underlying principles guiding the use of FLO were the same for each of these projects, project goals, the types of roles involved and how the projects evolved, spread and were sustained, varied considerably between settings.

Influenza Vaccination of Healthcare Workers: Critical Analysis of the Evidence for Patient Benefit Underpinning Policies of Enforcement.

Background: Four cluster randomized controlled trials (cRCTs) conducted in long-term care facilities (LTCFs) have reported reductions in patient risk through increased healthcare worker (HCW) influenza vaccination. This evidence has led to expansive policies of enforcement that include all staff of acute care hospitals and other healthcare settings beyond LTCFs. We critique and quantify the cRCT evidence for indirect patient benefit underpinning policies of mandatory HCW influenza vaccination.

Longitudinal Multicenter Analysis of Outcomes After Cessation of Control Measures for Vancomycin-Resistant Enterococci.

OBJECTIVE To assess clinically relevant outcomes after complete cessation of control measures for vancomycin-resistant enterococci (VRE). DESIGN Quasi-experimental ecological study over 3.5 years.

The Effect of Hospital Isolation Precautions on Patient Outcomes and Cost of Care: A Multi-Site, Retrospective, Propensity Score-Matched Cohort Study.

Background: Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes.

Objective: To examine the effect of isolation precautions on hospital-related outcomes and cost of care.

Interventions to improve patient hand hygiene: a systematic review.

Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014.

Domestic impact of tuberculosis screening among new immigrants to Ontario, Canada.

Background: All Canadian immigrants undergo screening for tuberculosis (TB) before immigration, and selected immigrants must undergo postimmigration surveillance for the disease. We sought to quantify the domestic health impact of screening for TB in all new immigrants and to identify mechanisms to enhance effectiveness and efficiency of this screening.

Methods: We linked preimmigration medical examination records from 944,375 immigrants who settled in Ontario between 2002 and 2011 to active TB reporting data in Ontario between 2002 and 2011.

Hand hygiene monitoring technology: a systematic review of efficacy.

Electronic and video monitoring systems (EMS/VMS) may improve hand hygiene by providing feedback, real-time reminders or via the Hawthorne effect. The aim of this systematic review was to assess the efficacy of EMS/VMS in improving hand hygiene or reducing the incidence of healthcare-associated infection (HCAI). Experimental and quasi-experimental studies were included if they measured any hand hygiene outcome and/or HCAI incidence.

Infection related to ultrasound-guided single-injection peripheral nerve blockade: a decade of experience at toronto Western hospital.

The use of ultrasound guidance has revolutionized regional anesthesia practice. Ultrasound equipment disinfection techniques vary between institutions. To date, there are no large data set publications or evidence-based guidelines that describe risk-reduction techniques for infectious complications related to the use of ultrasound guidance for peripheral nerve blockade.

Measurement of patient hand hygiene in multiorgan transplant units using a novel technology: an observational study.

Objective: Healthcare worker hand hygiene is known to prevent healthcare-associated infections, but there are few data on patient hand hygiene despite the fact that nosocomial pathogens may be acquired by patients via their own unclean hands. The purpose of this study was to measure patient hand hygiene behavior in the hospital after visiting a bathroom, before eating, and on entering and leaving their rooms.

Design: Cross-sectional study.

Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study.

Background: The Hawthorne effect, or behaviour change due to awareness of being observed, is assumed to inflate hand hygiene compliance rates as measured by direct observation but there are limited data to support this.

Objective: To determine whether the presence of hand hygiene auditors was associated with an increase in hand hygiene events as measured by a real-time location system (RTLS).

Methods: The RTLS recorded all uses of alcohol-based hand rub and soap for 8 months in two units in an academic acute care hospital.

A pragmatic approach to infection prevention and control guidelines in an ambulatory care setting.

The vast majority of infection prevention and control (IPAC) experience and practice guidance relates to the inpatient setting. We have taken a pragmatic approach to applying IPAC guidance in our ambulatory setting, and here we identify and describe the 4 key areas where we modified our IPAC program and adapted current guidelines to fit with our setting.

Patient-as-observer approach: an alternative method for hand hygiene auditing in an ambulatory care setting.

A survey pilot asked patients to observe the hand hygiene compliance of their health care providers. Patients returned 75.1% of the survey cards distributed, and the overall hand hygiene compliance was 96.

Integration and proliferation of Pseudomonas aeruginosa PA01 in multispecies biofilms.

Despite an increased awareness of biofilm formation by pathogens and the role of biofilms in human infections, the potential role of environmental biofilms as an intermediate stage in the host-to-host cycle is poorly described. To initiate infection, pathogens in biofilms on inanimate environmental surfaces must detach from the biofilm and be transmitted to a susceptible individual in numbers large enough to constitute an infectious dose. Additionally, while detachment has been recognized as a discrete event in the biofilm lifestyle, it has not been studied to the same extent as biofilm development or biofilm physiology.

Mild isoniazid-induced liver injury in humans is associated with an increase in Th17 cells and T cells producing IL-10.

Isoniazid (INH) remains a mainstay for the treatment of tuberculosis despite the fact that it can cause liver failure. The mechanism of INH-induced liver injury remains controversial. It had been proposed that the mechanism involves metabolic idiosyncrasy based on the observations that liver injury is not usually associated with fever, rash, or prompt increase in alanine aminotransferase (ALT) upon rechallenge.